Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | 08002130A | IN |
NPI | 1003984113 |
---|---|
Provider Name | Dr. Christopher Lee Hyde |
First Address | Indianapolis, IN 46278-1420 |
Second Address | Indianapolis, IN 46278-1420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000483304 | (02) | IN |